Ohio owes $29.5M for improper Medicaid bonuses, feds allege

The federal government gives bonuses to offset the cost of increased Medicaid enrollment, but maintains in its report that the bonuses are not for children who are blind or have disabilities.

The federal government gives bonuses to offset the cost of increased Medicaid enrollment, but maintains in its report that the bonuses are not for children who are blind or have disabilities.

The Ohio Department of Medicaid owes back $29.5 million in bonuses that the federal government said wouldn’t have been paid out if Ohio had counted its enrollment numbers properly.

Ohio Department of Medicaid disputes the federal report.

The dispute centers around whether Ohio should have counted children who are blind or have disabilities in its Children’s Health Insurance Program enrollment numbers when it comes to certain federal bonuses.

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The U.S. Department of Health and Human Services Office of Inspector General gives bonuses to offset the cost of increased Medicaid enrollment, but maintains in its report that the bonuses are not for children who are blind or have disabilities.

The inspector general's office reported nearly half of the $64 million in bonus payments Ohio received between 2010 and 2013 were improperly received.

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Michelle Horn, chief financial officer for Ohio Medicaid, stated the state maintains its numbers were submitted in accordance with the law’s intent, and Centers for Medicaid and Medicare’s approach for calculating bonuses “is in opposition to Congressional intent meant to reward states for increased enrollment of all eligible children, not just non-disabled eligible children.”

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The federal report says that Ohio overstated its eligible enrollees each year between 2010 and 2013, with the number of improper enrollees ranging from between 40,925 and 33,851.

That translates to disputed annual bonuses between $4.7 million and $10.8 million during those years.

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